ISLAMABAD (BLOOMBERG) - Pakistan is at risk for a second wave of coronavirus infections during the upcoming Eid holidays as millions travel to their home towns and mingle at family and religious gatherings.
The South Asian nation - with the second highest number of infections in Asia - has had some respite over the last few weeks with the rate of new infections slowing.
But experts warn the chances of a resurgence are high, with Friday (July 31) marking the start of the religious holiday. And they say it's difficult to assess the path of the nation's epidemic because its testing rate remains one of the lowest in the world.
"Eid al-Fitr will draw millions of people into crowded fairs and religious and family gatherings," said Steve Hanke, professor of Applied Economics at Johns Hopkins University.
"Masks and social distancing will be abandoned, and similar to the Chinese New Year in Wuhan, Eid al-Fitr could become a cataclysmic event for Pakistan and the region."
Pakistan will also have to manage Muharram processions in late August, when large crowds of Shiite Muslims gather to praise and mourn Imam Hussain, the grandson of Prophet Muhammad killed in the battle of Karbala. Globally, religious gatherings have sparked several virus clusters.
Prime Minister Imran Khan's government said last month its estimates showed the pandemic will reach its peak by the end of July with 1.2 million reported cases.
As of Tuesday. the country had reported more than 275,000 confirmed cases with 5,900 deaths. The country's cases rose by 3.7 per cent last week, the slowest pace since the outbreak began in Pakistan.
Unreported Infections Qatar Airways and Emirates are among the airlines that have made it compulsory for travellers from Pakistan to get tested before travel.
Meanwhile, Pakistan has stopped testing incoming travelers - one reason for a drop in testing rates and new confirmed cases.
"The significance of the drop is that cases are likely being highly underreported," said Hanke in an emailed reply.
Khan has downplayed the seriousness of the virus, but his administration has advised caution.
"Any complacency and we will face the same increase we saw earlier," said Faisal Sultan, the prime minister's point person for Covid-19 strategy and an infectious disease expert.
The reason for the recent drop in cases "is harder to know but is likely multi-factorial. The biology of the epidemic including interplay of host, pathogen and environment but also interventions have likely helped."
The pressure on Pakistan's hospitals has also eased with patients on ventilators and low flow oxygen dropping by more than 50 per cent since June 20, Faisal said.
Data Deficit Pakistan's largest pharmaceutical manufacturer Getz Pharma tested 24,210 people in mostly urban workspaces. Its study then extrapolated those findings to the urban, adult, working population of Pakistan and found active Covid-19 infections would likely reach 4.11 million, which is almost 15 times higher than the current tally.
The positivity rate for those tested in the study was 17.5 per cent, higher than government data that shows the rate dropping to below 5 per cent from more than 20 per cent in June.
Pakistan's medical associations and experts have long warned that low testing and lack of data means there is an underbelly of virus cases that don't appear in official figures.
Serology tests, private hospital data and many virus-related deaths are not being reported in the government's official numbers, said epidemiologist Wajiha Javed, head of public health and research at Getz Pharma.
"The initial peak was two weeks post Eid and we may expect second peak at two weeks post the second Eid."